Ronibats.PH Stories of a Filipino neurosurgeon, teacher, and writer

First-Generation Doctor


It was Saturday morning, and by force of habit, I woke up early even though I had nothing scheduled for the day. It was the end of my second week in private practice. Lying in bed, staring at the circular lamp set against a deep blue background which is my bedroom ceiling—meant to simulate a full moon on a starless night sky—I wondered if I had made the right decisions thus far.

Nine years had passed since I graduated from medical school and got my license to practice medicine, two years since I finished residency to become a neurosurgeon, and one year since I completed my pediatric subspecialty training abroad, yet I was, still, just at the beginning. My work as a teacher would usually keep me preoccupied—I had only recently concluded my biochemistry review for students preparing to take the physician licensure examination. My neuroanatomy classes for first year medical students were not due to start until a couple of months later. Though I refused to admit it, anxiety was building up.

I knew I had to moderate my expectations, having heard the same story from classmates and friends. Pagalingan magbilang ng butiki sa kisame ng clinic. I should even consider myself lucky; I had one patient on my first day.

So when the demons started to creep at the fringes of my deep-blue sky, at the ready to cast frustration and doubt, I got up, took a shower, and did what any self-respecting patient-less physician would do: I cleaned my apartment. Nothing could clear my mind faster than washing the dishes.

Being a first-generation doctor, I had to start from scratch. My parents are not doctors. No one among my immediate maternal and paternal relatives is a doctor. My family cannot afford to buy shares of stocks in private hospitals. After finishing specialty and subspecialty training, I did not have a clinic to take over and neither did I have practice privileges waiting to be used. As to which course my neurosurgical career would take, whether things would pan out after I obtained my diplomate certificate at the end of last year, there was no way to be certain. Where to begin? How to begin? I was on my own.

I suppose every Filipino physician goes through this stage. It is like standing on a cliff with an immeasurable vertical drop, your heart in your outstretched hand, and it’s raining hard but you cannot do anything except let the wind and water batter you as you shout, hoping the universe hears you amidst the intermittent thunder: here I am!

Was it right to stay in the Philippines to practice medicine? Was it the correct decision to come back after my fellowship training? What happens if things do not work out as I had envisioned then as an idealistic, young Filipino doctor?

On my last day in Melbourne, I took an Uber to the international airport. My driver was an immigrant from Malaysia, an engineer, and I told him I was a Filipino doctor leaving Australia for good. It was my father’s sixtieth birthday the following day and I would make it just in time. I did not look for another training program after my year-long contract at the chidren’s hospital ended. I did not explore the possibility of permanently working and settling in the country either, although I could have as many did.

“You should have stayed here!” my driver said in disbelief while we were on the freeway, in the same tone one’s friends would say, “Ang tanga-tanga mo!” with good intentions. As he admonished me, a Ganesh figurine stood witness on the dashboard. The Hindu deity was the good omen that I needed.

Back in Manila, my worth as a physician has been reduced to an envelope of photocopied diplomas, licenses, and certificates, which I carry around as I do courtesy calls to senior neurosurgeons, turn up for interviews, and apply for a consultant position at different hospitals. Residency and fellowship trainingopen doors of opportunities, but they do not necessarily mean patients will beat a path to your door. That is the caveat.

I had to learn the intricacies of Philippine taxation, PhilHealth, and setting up a clinic. My secretary would teach me how to charge professional fees, something I still feel uncomfortable discussing with my patients’ families. It was a moment of triumph, holding up my completed income tax return, which I filed on my own because I wanted to save on accountant fees. I compute every single peso I shell out for my clinics.

Most work days, I spend three hours driving between hospitals and medical schools. It was one of those mornings when, stuck in traffic inside my secondhand car, I told myself that I just want to earn enough so that I would not have to worry about gasoline, toll fees, and parking.

One good thing going for me is that I have been able to save money while I was training abroad. I earn a decent income when I teach in medical schools, too. Living in laid back Melbourne for a year taught me to enjoy the slowness of things. Everybody is in such a hurry to achieve something or become someone, that we forget to be thankful for what we have in the now. We are always where we are meant to be.

More than ever, I would turn to my consultants for advice. I realized that although peers are conveniently available for sharing daily frustrations, it is wisdom that comes with age and experience that helps one make the right decisions.

Just make sure that you don’t take in more than you can chew. Other opportunities will come your way as time passes. Pick the options that will make you happy. Good luck.

I had been told of this just recently, and as a first-generation doctor, it is advice like this from a mentor that provides reassurance.

That Saturday morning, at the end of my second week in private practice, I decided to give myself a deadline before seriously considering plan B. Maybe even plan C.

While I was walking home after paying my apartment’s electricity bill, the universe responded to my cliff monologue with a text message from Dr. AS, a senior neurologist, and one of my teachers at the UP College of Medicine. She was also the very person who interviewed me for medical school admission sixteen years earlier.

“Ronnie are you in town?”

I replied to her message. She called shortly after to discuss a patient, an elderly father with a head injury.

That was how I got my first neurosurgical referral as a consultant.

About the author

Ron Baticulon

Ronibats is a pediatric neurosurgeon, teacher, and writer. In 2018, he won a Palanca award for the title essay of his first book, "Some Days You Can't Save Them All," published by The University of the Philippines Press. You can follow him on Twitter @ronibats.


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  • This might be cliche and redundant but yes, we all go through that stage of uncertainty, finally facing up the unknown and anxieties “of that cliff”. There’s value to what our senior consultants and mentors tell us. Just do what you love most, have fun and the rest will come your way.
    Oh, if this may help calm your “financial uncertainties”, I have yet to see a physician die of hunger even while at the rock bottom of practice. Take that from someone who did…:)

    You’ll do fine. Ikaw pa.

    • Yes bai, I agree. It’s only a matter of deciding: what level of comfort would you want for yourself and your family? I wrote this so that years from now, I would not forget how it all started. 🙂

  • I could totally relate, I am in my 3rd month of private practice. hehehe I consider myself lucky to have 4 private patients last month in my own clinic. hahaha! Congratulations to us! hahaha I still borrow money from my parents at times when it was really tough. I have not fully applied for hospital affiliations yet as I want to take the diplomate exams in my specialty.

  • I was inspired dockie To your story… But as for my experience i shifted to Plan B..
    1 year after i have my private practice as A General Pediatrician.. Maybe because of Pressure to my parents and to myself..I self pity for all those moments na nagbibilang ka ng butiki sa other says… Then at my age, ang hirap kumita for your own financial support..housing bills…house rent..foods..
    Pamasahe for my Moonlighting stints not only as Gen.Pediatrician but all pati medics sa ambulance at construction napasukan ko.. Then, all of a sudden.. Bigla ako napa isip for my Plan B?? Is it okay or better for me?? And That the Time Plan B opportunity came.which is My Stint For Abroad here in Oman.. I.was thinking walang patumpik.tumpik.single.naman ako..and 2-4 x higher ang grab the.opportunity…
    Pero Iba pa din pala dyan sa Pinas… Mas okay pa din..
    So. My thoughtss now is To finished my contract now and go.back to homeland there.. I am 3 years and half na din dito and my konting savings and investments na which will i call my own…its serve my purpose na..It is not always the money but Tne passion ,love and Patience To our craft.. Maybe I will.go.back there but merely as Businessman.Part time pediatrician ..hehehe…

  • This is one of the reasons I chose anesthesia. No clinic=no overhead. I started as an associate and a hospitalist to have a “guaranteed income” to feed my family. My clients are not the patients really, but the surgeons and obstetricians who refer cases to me. After almost 10 long years, I finally saved enough to buy stocks in the hospital where I started my career. Iba talaga pag may stocks or pambili ng stocks ang parents. Pero ok lang, part of the journey lahat yan. Sometimes it makes it even sweeter, knowing how much you had to crawl to get there.

    • Hi DIDOSMOM. Is there any way for me to contact you? I’m really interested in anesthesia private practice here in the philippines. I’m far off from being a doctor yet, but I could use some advice.

  • Thank u doctor ronibats. My daughter mentioned about u being their teacher in neuroana. Thank u doc for being an inspiration not only to medical students but to fellow doctors as well. I have read some of your posts esp abt healthcare n the philippines. I also worked with the govt, im a medical officer in our place. Relate much talaga ako sa mga sinabi mo doc. I am wd u in hoping that someday healthcare in the philippines will be better.

  • Congratulations on your first private case, Dr. Ronnie! I’m sure you’ll do great as a consultant. I pray that you’ll have more opportunities to share and hone your expertise. God bless you, Sir.

      • You’re welcome po, Dr. Ronnie. I first heard about you in KMJS’s Pamilya Valedictorian episode. Then last month (or earlier this month), your article “5 valedictorians in the family” was featured among Rappler’s Top In Mood. That was when I saw a link to your beautiful blog, and I could not stop reading since then.

        I hope you’ll have more strength and time to keep telling their (and also your) stories, Doc. Each story warms the heart, enlightens the mind, and feeds the soul.

  • Relate much ako sayo sir. I am currently in my 5th month of practice as a gastroenterologist, after graduating last year I took a part-time med specialist job at our politically-challenged provincial hospital which pays 15k/mos for 20h/wk work. Not so much but it got me through those first few mos of practice na talagang walang-wala. No choice kasi may asawa’t anak na rin ako, kahit pang-gatas lng ok na. Like you I am lucky to have supportive mentors, to talk to and seek counsel especially kung may problema. Somehow, nakakara-os na din. Gud luck sir, I wish the best for you and all those physicians who starting their own practice.

    • I hope you get your PhilHealth payout too, Lupin. Dun lang din nakakabawi yung mga kaibigan ko who got government positions. I’ve got an appointment with UP, so that’s also steady income kahit paano. All the best to you din. We just keep are fingers crossed. 😉

  • Wow. Thank you for this. I’ve read your post and the comments too. It’s nice knowing there are other doctors going through the same thing as I am. We’re in that career limbo of fulfilling the dream of helping others but you have to help yourself too.
    After graduating med school, I’ve already realized that I cannot stand a career of just being a clinician. I just graduated from my training so I’m still in the midst of vacation/planning my life. I’m thinking of applying as a teacher in a med school too (to give back) and getting some consultancy public health work. It’s really frustrating when you have to start every thing from scratch. Here’s to our transition year!

    • Same same That Feeling dockie.. Im also Gen Peds but not yet diplomate kasi mas pinili ko mag Ofw for the mean time….. :,)

    • Great to hear from you, First Gen Pedia! When I wrote this, I didn’t realize that the article would resonate so well with many physicians. I guess it’s just one of those mutual experiences that bind us. Yes, cheers to our transition year, and I wish you all the best!

  • I was a medical doctor in the Philippines but I migrated to New Zealand after I finished my Master in Public Health in UP Manila. I was a medical board topnotcher. And just like every doctor is, I was very idealistic. I went into medicine because I wanted to save the world. But up to this very day I regretted my decision to have chosen medicine as my profession. My two sisters chose engineering. Immediately after graduation they got high paying jobs and their profession is recognized all over the world without having to take registration exams in developed countries. And how many years did they have to study? Only 5 years. What is the point of becoming a doctor if you can’t support yourself financially? Because you want to save people’s lives. It’s bullshit. You have to save yourself first. Just like you I was a first generation doctor and it was so difficult because I didn’t inherit any practice and nobody was there to advice me what to do. I had a mental breakdown because of residency training because I was bullied. There was so much going against me as doctor. And what’s worse was I was still asking money from my parents after more than 10 years of study while my sisters were buying lands of their own. Now I’m happier. I’m not working as a doctor but as a lecturer in a university in New Zealand and on my way to studying PhD with so.much less stress and more money in the bank. The best part I am really enjoying my job.

    • Hi doctor, I was searching around looking for filipino doctors working in new zealand as general practitioner and this article from doc bats came (hi doc! =) ) Is it possible that I may connect with you in any messaging platform as I would like to ask few questions related to this? Thank you so much. I am a general practitioner here in the Philippines for 2 years now and planning to migrate in NZ and continue my practice there. i hope I can connect with you, thank you.

  • Oh my. I still remember your blog back when you were in med school. Look at you now. Gah! I feel so old. Don’t forget to read back your blogs from before. It might help you connect with your students. Remember, you were them not so many years ago. Good luck on your journey from one alumni to another. I’m sure you will be just fine.

  • Thank you for this.

    I just graduated from pediatrics residency and yes — the dilemma of being a first gen doctor, from a middle income family, solo upbringing a child and desire to pursue fellowship.

    I’m out of training for now hoping to save enough even just to pay for my child’s tuition fee prior to applying for my fellowship. Initially, I tried the 80hr work/wk but being fresh from residency, I think I almost burned out. It’s hard because I did take more than I can chew and I went on despite not being happy anymore. I wish I also heard from that wise prof who reminded you about that.

    I’m still finding my own balance. I am thankful for knowing in my heart that this is what I would like to do until I grow old but I still worry everyday (since I don’t have personal connections) that there may come a time that I won’t have patients to work with.

  • Thanks for sharing your insights Dr! Physicians ought to learn the value of delayed gratification. Success will come eventually after we have sincerely helped a lot of people and if we truly love what we are doing.

  • Hi Doc Ronibats! I became a fan after reading the Valedictorians in the family article in the Philippine Daily Inquirer. I have read several of your articles. Now that my daughter Sheena who after passing the medical board last 2015 and having married last year, was found to have a mass in her cervical spine, I remembered you. And YES you are now a practising Neurosurgeon. I remember my daughter telling me during her review at Topnotch that even though you were in Australia back then, the video-recorded lecture you delivered was enjoyable. She enjoyed your lecture on Biochem very much and her highest score in the board exam turned out to be Biochem!
    I’m sure you will have a lot of patients in the very near future.
    May GOD bless you and your Family !

  • Hello Doc! I just graduated from med school and will start my emergency medicine residency in NYU Langone. Katulad mo I’m also a UP alumnus I graduated BS Nursing, got two years of experience as a nurse in Manila then med school dito. At first my journey towards becoming a doctor was almost impossible. Hindi kami mayaman to begin with, I barely afforded my education in UP Manila then until some relatives started helping me. I was really eager to become a doctor so pinagbutihan ko talaga when I was still a nurse there in Manila. Inaral ko lahat ng nursing procedures and I used to ask a lot from our IM consultants which really helped me later on. When I came here in NY madami pa akong pinagdaanan, nandyan yung nag post bac pre med ako for 2 years kasi hindi tinatanggap ng mga med schools dito unless macover mo yung mga prerequisites nila. Bukod dun kailangan madami kang extracurricular like shadowing which is nakakaubos ng oras pero dahil kailangan sige lang. Nung natapos na ako sa post bac ay nag MCAT na ako at medyo mataas naman nakuha ko. Mahirap mag apply sa med school kasi international student ako at bibihira lang ang tumatanggap sa kagaya ko. So nagtiyaga talaga ako. I got denied at 5 schools at dun siguro tinanggap ko na yung kapalaran ko na baka hindi talaga para sakin ang medicine. Pero kinabukasan tinawagan ako ng isang ivy league school at nireconsider ako for an interview. Naging honest ako sa mga sagot ko. Hindi ako nagplay safe sa mga sagot ko sa interview at luckily, pumasa naman. 6 years later ay nakagraduate din ako at magstart as emergency medicine resident. Thank you doc kasi nainspire ako sa mga sinulat mo before. Sa tuwing mawawalan ako ng pag asa ay binabasa ko ang blog mo at nagiging positve ako na nagwowork ang lahat. Hope to meet you Doc Roni. God bless you!

    • Hi Raphael, we are always where we are meant to be. You do realize that a lot of people would want to be in your place at the moment, and you should be grateful for that! 🙂 I wish you the best in your residency training. It will be difficult, for sure. But you’ve neen through a lot, you know the drill. Maybe when I get to go to New York next, you could say hello. Pero hindi naman ako artista! Pay it forward Raphael, I’m sure you will be just fine 🙂

      P.S. Diyan ata sa NYU Langone si Mike Natter, yung MD na magaling mag-illustrate!

  • Hello doc, I just recently passed the board exam. Had my review in topnotch that’s how I came across your blog. Reading this story scared me doc. I too am a first gen physician.
    From your story, you asked the questions after your traning doc. As for me, I have already been thinking hard on life after boards doc, on what to do next and having to constantly deal with the question ‘What specialty are you going to take?’. Truth is, I don’t know what I want to do doc but I know I want to heal people and at the same time stop being dependent on my parents (who supported me through med school). I also thought of moonlighting to earn but I’m asking myself ‘What if I want to train in the future and I’m wasting my time?’. I am not a student with the best transcript that can get in easily into training after moonlight, I am just average doc. Also, training but deciding hastily what I want to train might lead me to disappointment, regret and quitting in the future which I don’t want to do either.
    Maybe I’m thinking too much? Or having misconceptions? I don’t know doc.
    Can I ask doc, if that it’s okay, what would you have told yourself then if you were fresh out of boards with no specific plan and have been asking the questions you are asking now?

  • I wish I can find time to grab a bite or take a leak during my emergency medicine days. Working for an emergency medicine department that sees 1500patients/day. A moment to turn your back to face the computer to document your care of the patient means other patients will wait longer. Gone were the days. I move to an urgent clinic where I don’t feel disappointed seeing patients in the ER waiting like luggages on a conveyor belt, where I can spend more time enjoying the art of healing and not to satisfy bosses of cutting waiting times and documentation takes more of your time than listening and advising your patients. We see 30 patients in a 12 hour shift though but the life work balance and work is better and work satisfaction is greater and you see more patients’ happy faces.

  • We all go through that stage of uncertainty, of the unknown and anxieties of the cliff. But how would you know if you stick to plan A or shift to plan B or C. You say, do what makes you happy. But, what if you no longer know what makes you happy anymore?

  • I can attest to this… bec I myself is a first generation MD… no clinic of my own, no stocks… I have to earn my way… so I ventured into the corporate world…regular wirkung hours, good pay… plus side rakets every Sat as a physician… time to time I took aesthetuc training and hopefully will open my own aesthetic clinic…

  • Made me cry!
    Currently on my 8th month of private practice
    Pa isa isang patient
    Ndi alam saan kukuha ng pambayad sa expenses..

  • Hi! Doc. Nung isang araw pa ako naghahanap ng motivation to push through sa pagiging doctor so I really thankful for this. As a first generation doctor din, sobrang natatakot ako kahit first year college pa lang ako. Wala akong connections and I’m not sure kung kakayanin ang pang tuition sa med. Pero hopefully, things will work out.

Ronibats.PH Stories of a Filipino neurosurgeon, teacher, and writer